Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Keanu Irene Hackley

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1164188090

Keanu Irene Hackley is a Student in an Organized Health Care Education/Training Program in Louisville, Kentucky. Registered with an NPI since 2021.

In the registry since
2021

Practice location Address checks out

204 E Market St # A
Louisville, KY 40202-1218
Phone: (502) 588-4340
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Student in an Organized Health Care Education/Training Program (primary) Taxonomy 390200000X

Record details

NPI number1164188090
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedNovember 15, 2021
Last updated in NPPESNovember 15, 2021
Certification dateNovember 15, 2021

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